A message from Dr Jacqueline McCandless re LDN

Tuesday, 07 June 2011

To whom it may concern (those interested in LDN particularly for children and adolescents):

I am receiving dozens of personal e-mails lately requesting information on LDN; I am sorry, I cannot personally answer all of them. For those of you wishing recent scientific studies for LDN, there are only a few, as a generic drug cannot make anyone a lot of money so it is difficult to get research money to do the studies that might be helpful. My personal studies done within my autism practice showing LDN's great safety and benefit have not been published. Very significant research in terms of the requests for information that I receive is Dr. Jill Smith's study from Penn State showing the benefits and safety of LDN in children and adolescents with Crohn' Disease, just recently published. I have gut-compromised children in my practice on LDN with great success, (and many adult auto-immune patients) and many thousands of children with autism take LDN, both as an immune enhancer and a mood regulator (parents call it the "happy cream)." As reported, LDN is effective, non-toxic, easy to apply as a cream or given as a capsule at bedtime only – its only contraindication is pain narcotics meds, or prescription immune suppressants – I allow those weaning off prednisone to start LDN when they are down to less than 10mg a day on their way to stopping it. Cream is easier for small kids who cannot swallow capsules and who often are asleep before 9 pm at night. It is easy for the parents to put the cream on their bodies while they are sleeping, rather than needing to awaken them to give them an oral very bitter medicine. Also, I believe those with gut issues may get better absorption with the cream, which is absorbed very quickly and has no odor (though may be bitter if a child tastes it).

Both capsules and the cream must be prescribed by a physician and compounded by a pharmacist who knows how to do it properly (no sustained release carriers are allowed – LDN must go in immediately as a bolus to be effective. Personally I prefer Emu Oil as the carrier for the cream and Avicel for the capsules). Dosage is by weight; 3mg under 100#, even as low as 1.5mg for tiny kids under 35#, 4mg for 100-125#, and 4.5mg for those over 125# regardless of age.

LDN can be given with or without food.

There is no formula as to how soon kids respond; moods often are clearly improved within several weeks, but the immune benefits which take at least 3 months are not usually so obvious, other than less allergies, colds/ear infections/flu-like syndromes.

I have noted that about 12-15% of kids (and sometimes even adults) may have a period, usually less than 10 days, of hyperactivity and even insomnia when first taking LDN. It is OK to give with melatonin, which helps many children with autism sleep better. If the hyperness is severe or lasts longer, it may mean they are hypersensitive to the large peptides in gluten and casein, and for autistic children this may certainly be a diagnostic indication that they would do better not only with LDN but generally in their lives with a gluten/casein (and usually soy)/free diet. Actually most kids (and adults!) do better without these foods, though I realize it is not always easy to remove them from their diet. However, I cannot tell you how many families over the years have reported to me that everyone in the family (when the whole family goes on this dietary restriction) feels better, has better gut function and better moods and behavior WITHOUT gluten and casein. (Removal of casein totally from diets of ADHD kids has now been reported to take 60% of them away from needing stimulant medication).

Jaquelyn McCandless MD